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Thread: Flushing decrease but still getting papules and pustules

  1. #1
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    Default Flushing decrease but still getting papules and pustules

    Hi,

    I have papular/pustular rosacea with background redness and flushing. I have had 6 IPL treatments (which i am sure didn't help at all) and one treatment with the Gemini laser. After this treatment my flushing has decreased significantly but i am still getting lots of p & p's. I look like a teenager with acne! I have tried every topical under the sun (metro cream, rosacea ltd discs, elidel, topical antibiotics etc). I do take minocycline which keeps helps a bit but I'm not sure whether continued laser treatments will help with the p & p's or not. I really don't want to take accutane and I would like to stop taking antiobiotics as well.

    Dr Nase - is there any new treatment on the horizon for this type of rosacea? Why do the p & p's keep appearing if the damaged blood vessels have been removed through laser?
    I live in Australia so do not have access to many of the treatments available in the US.

    Thanks

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    finacea

  3. #3
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    Default Flushing decrease but still getting papules and pustules

    Aren't p&p's the pits? ...no pun intended I've battled with them too and found that a combination of treatments has worked. I'm 54 so my doc put me on spironolactone to help with a possible hormone imbalance. Too much androgen as we get older can give women more p&p's. I tried minocycline but it didn't work nearly as well as doxycycline. I take a very small dose 40-60 mg/day. I also use metrogel 75% twice a day, wash with mild cleanser, no lotions, avoid sun, hot foods, etc. I also avoid ALL dairy products and this clinched it...I now rarely breakout. It's rather unsettling to think it takes all of these things to get clear skin but I've decided to bite the bullet as they say and just follow the regime. For way too many years I kept trying to do this half-ass and ended up with major flare-ups and red skin for most of my adult life.

  4. #4
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    Hi claudia,

    thanks for your reply. can you tell me more about spironolactone? Is it a supplement.

    It sounds like there are a few new treatments on the horizon but I live in australia so things take a while to get here. I don't think we have finacea available here yet.

    I thought the IPL and laser treatments would help for sure but my skin texture is absolutely no better.

  5. #5
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    Quote Originally Posted by pinkie
    Hi claudia,

    thanks for your reply. can you tell me more about spironolactone? Is it a supplement.

    It sounds like there are a few new treatments on the horizon but I live in australia so things take a while to get here. I don't think we have finacea available here yet.

    I thought the IPL and laser treatments would help for sure but my skin texture is absolutely no better.
    hi pinkie,
    just a quick note - we do have finacea in australia. a derm tried to give me some, even though i have no p&p's. dont know how good it is for rosacea though.

    - James.

  6. #6
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    Also, try a low carb diet. Many folks find that helps with the p&ps. At least cut out sugars and refined carbs. If there is a connection, you should see a dramatic difference w/in a very short period of time.

    Your other option is just more IPL/Genesis treatments. My understanding is that p&ps take more treatments to correct, then flushing.

    Not an uncommon situation your facing.

  7. #7
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    There's tons of info about spironolactone on the net Spironolactone is a very mild diuretic that's been around forever so it's been well studied and shown to have few bad side effects for longterm usage. It's spironolactone's good "side effects" that are helpful in treating blemishes. It curbs the production of androgens (testosterone) which in turn helps stop blemishes through decreased oil production.

    For me, due to my age, my body was starting to have less estrogen and thus more testosterone --- all of us have a balance of estrogen and testosterone that varies throughout our lives. And I probably always had a slight imbalance but that coupled with rosacea skin meant that I had deep cysts in addition to the usual p&p's. Two rounds of full strength accutane helped in my mid 30's but it came raging back in my mid 40's due to the natural loss of estrogen. When I was 50 my dr figured this out and put me on spironolactone which has totally stopped the deep hurting kind of zits. But I was still getting surface p&p's and inflammation which then led to the rosacea diagnosis at age 54.

    This is when I started the usual rosacea regime...but have found that the metrogel 1% and Doxycycline work the best along with dietary changes. You might want to read the thread on "More Alkaline - Less Red" for info on the benefits of eating more alkaline - lower glycemic foods.

    Hope this helps! Best of luck and hang in there
    Bactrim (phasing out), Spironolactone 1x/day, Retin-a cream .05% in the p.m., Neutrogena Cleanser for Sensitive Skin, avoid dairy and usual Rosacea triggers.

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